31.2

Question 1

loss of consciousness after regional anesthesia for ophthalmic surgery- oversedation

Answer 1

may, or may not be present

Question 2

loss of consciousness after regional anesthesia for ophthalmic surgery- brainstem anesthesia

Answer 2

likely

Question 3

loss of consciousness after regional anesthesia for ophthalmic surgery- intravascular injection

Answer 3

likely

Question 4

apnea after regional anesthesia for ophthalmic surgery- oversedation

Answer 4

may or may not be present

Question 5

apnea after regional anesthesia for ophthalmic surgery- brain stem anesthesia

Answer 5

likely

Question 6

apnea after regional anesthesia for ophthalmic surgery- intravascular injection

Answer 6

may or may not be present

Question 7

cardiac instability after regional anesthesia for ophthalmic surgery- oversedation

Answer 7

may or may not be present

Question 8

cardiac instability after regional anesthesia for ophthalmic surgery- brainstem anesthesia

Answer 8

likely

Question 9

cardiac instability after regional anesthesia for ophthalmic surgery- intravascular injection

Answer 9

may or may not be present

Question 10

seizure activity after regional anesthesia for ophthalmic surgery oversedation

Answer 10

not present

Question 11

seizure activity after regional anesthesia for ophthalmic surgery brainstem anesthesia

Answer 11

not present

Question 12

seizure activity after regional anesthesia for ophthalmic surgery intravascular injection

Answer 12

likely

Question 13

contralateral mydriasis after regional anesthesia for ophthalmic surgery oversedation

Answer 13

not present

Question 14

contralateral mydriasis after regional anesthesia for ophthalmic surgery brainstem anesthesia

Answer 14

may or may not be present

Question 15

contralateral mydriasis after regional anesthesia for ophthalmic surgery intravascular injection

Answer 15

not present

Question 16

contralateral eye block after regional anesthesia for ophthalmic surgery- oversedation

Answer 16

not present

Question 17

contralateral eye block after regional anesthesia for ophthalmic surgery brainstem anesthesia

Answer 17

may or may not be present

Question 18

contralateral eye block after regional anesthesia for ophthalmic surgery intravascular injection

Answer 18

not present

Question 19

epinephrine

Answer 19

a & b adrenergic agonist

systemic effect- hypertension tachycardia cardiac dysrhythmias leads to decrease intraocular pressure and can be used for glaucoma

Question 20

cyclopentolate

Answer 20

anticholinergic

systemic effect- disorientation, psychosis, convulsion, dysarthria

Question 21

phenylephrine

Answer 21

a adrenergic agonist

systemic effect- hypertension- 1 drop or 0.05ml of a 10% solution contains 5mg of phenylephrine

Question 22

scopalamine

Answer 22

anticholinergic

central anticholinergic syndrome

Question 23

atropine

Answer 23

anticholinergic

systemic effects- central anticholinergic syndrome- xerostomia, anhidrosis

Question 24

echothiophate- MOA

Answer 24

irreversible cholinesterase inhibitor

Question 25

echothiophate- systemic effects

Answer 25

prolongation of succinylcholine effects reduction in plasma cholinesterase activity up to 3-7 weeks after d/c

Question 26

acetazolamide moa

Answer 26

carbonic anhydrase inhibitor

Question 27

acetazolamide systemic effect

Answer 27

diuresis, hypokalemic metabolic acidosis

Question 28

timolol-moa

Answer 28

b adrenergic antagonist

Question 29

timolol- systemic effects

Answer 29

atropine resistant bradycardia, bronchospasm exacerbation of congestive heart failure possible exacerbation of myasthenia graves.

Question 30

acetylcholine moa

Answer 30

cholinergic agonist

Question 31

acetylcholine systemic effect

Answer 31

bronchospasm bradycardia hypotension

Question 32

sentinel events related to the preoperative period as defined by the joint comission

Answer 32

hemolytic transfusion reaction

invasive procedure on the wrong patient wrong site or wrong procedure

prolonged fluoroscopy >1500rads

fire flame or unanticipated smoke heat or flashes during an epidode of patient care

an intrapartum maternal death or severe morbidity

Question 33

key aims for success in outpatient anesthesia

Answer 33

maintain a predictable environment through critical case and procedure selectivity

promote a culture of diligence and patient safety that exceeds that of the hospital setting

monitor peer reviewed literature and track patient outcomes and experience to develop evidence based best practice

standardize workflow and best practices that leverages predictability to create consistently excellent outcomes for patient families and surgeons

Question 34

can a physician own an outpatient clinic

Answer 34

no it must be a physician group, hospital, investment group or non physician investors

Question 35

operating room precautions for laser surgery- preoperative period

Answer 35

arrange surgical drapes to avoid aaccumullation of combustible gases

allow time for flammable skin preparation to dry

moisten gauze and sponges in vicinity laser beam

Question 36

intraoperative period precautions for laser surgery

Answer 36

alert surgeon and or personnel about ignition risk
assign specific roles to each or member in case of fire
use appropriate laser resistant ett
reduce inspired 02 to a minimum value
replace n20 with air
wait a few minutes after steps 3-5 before activating laser

Question 37

when do we extubatne t&a

Answer 37

awake-some like to extubatne while patient is still under

Question 38

nerve blocks do what to patients satisfaction and decrease what post op

Answer 38

increase patient satisfaction and decrease ponv and post op pain

Question 39

how much versed do we give preop

Answer 39

0.01mg/kg

Question 40

anxious child

Answer 40

0.25mg/kg

Question 41

anxious patient the night before and day of take what

Answer 41

2-5mg versed

Question 42

robinol normal dose

Answer 42

7-15mcg/kg